Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods: Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. Results: 984 patients (median age 84 years, IQR = 79–89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19–2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02–3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85–7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21–4.66, p < 0.001). Conclusions: POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.

Gandossi, C., Zambon, A., Ferrara, M., Tassistro, E., Castoldi, G., Colombo, F., et al. (2023). Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study. AGING CLINICAL AND EXPERIMENTAL RESEARCH, 35(11), 2499-2506 [10.1007/s40520-023-02522-8].

Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study

Gandossi, Chiara Maria;Zambon, Antonella;Ferrara, Maria Cristina;Tassistro, Elena;Colombo, Francesca;Zatti, Giovanni;Bellelli, Giuseppe
2023

Abstract

Background: This study analyzes the effect of frailty and Post-Operative Delirium (POD) on the functional status at hospital discharge and at 4-month follow-up in patients with hip fracture (HF). Methods: Multicenter prospective observational study of older patients with HF admitted to 12 Italian Orthogeriatric centers (July 2019-August 2022). POD was assessed using the 4AT. A 26-item Frailty Index (FI) was created using data collected on admission. The outcome measures were Cumulated Ambulation Score (CAS) ≤ 2 at discharge and a telephone-administered CAS ≤ 2 after 4 months. Poisson regression models were used to assess the effect of frailty and POD on outcomes. Results: 984 patients (median age 84 years, IQR = 79–89) were recruited: 480 (48.7%) were frail at admission, 311 (31.6%) developed POD, and 158 (15.6%) had both frailty and POD. In a robust Poisson regression, frailty alone (Relative Risk, RR = 1.56, 95% Confidence Intervals, CI 1.19–2.04, p = 0.001) and its combination with POD (RR = 2.57, 95% CI 2.02–3.26, p < 0.001) were associated with poor functional status at discharge. At 4-month follow-up, the combination of frailty with POD (RR 3.65, 95% CI 1.85–7.2, p < 0.001) increased the risk of poor outcome more than frailty alone (RR 2.38, 95% CI 1.21–4.66, p < 0.001). Conclusions: POD development exacerbates the negative effect that frailty exerts on functional outcomes in HF patients.
Articolo in rivista - Articolo scientifico
Delirium; Frailty; Functional outcome; Hip fracture; Orthogeriatric;
English
5-ago-2023
2023
35
11
2499
2506
open
Gandossi, C., Zambon, A., Ferrara, M., Tassistro, E., Castoldi, G., Colombo, F., et al. (2023). Frailty and post-operative delirium influence on functional status in patients with hip fracture: the GIOG 2.0 study. AGING CLINICAL AND EXPERIMENTAL RESEARCH, 35(11), 2499-2506 [10.1007/s40520-023-02522-8].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/434338
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